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January 07, 2003

Episiotomy

A significant number of women coming to our post-partum clinic have had episiotomies. Some of them seem to have some discomfort from it. Are episiotomies really necessary?

Episiotomies should not be performed routinely according to WHO and other authorities. Episiotomy should only be considered for certain special situations such as a complicated vaginal delivery.

Nevertheless, the practice remains all too common. For example a study of 122 hospitals in 16 Latin American countries (though strongly weighted to Argentina and Uruguay) found a median episiotomy rate for women's first delivery of 92.3%. This rate was fairly constant across level of hospital and type of provider. Rates may not be as high in other places, but still we obviously have a long way to go.

References:
WHO, Department of Reproductive Health and Research. Managing complications in pregnancy and childbirth: A guide for midwives and doctors. 2000 (HO/RHR/00.7)

Althabe F, Belizan JM, Bergel E. Episiotomy rates in primiparous women in Latin America: hospital based descriptive study. BMJ 2002;324:945-6.

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The "Pearls" offer answers to commonly asked questions about family planning. These "Pearls" are prepared by Dr. James D. Shelton, Senior Medical Scientist, Office of Population, United States Agency for International Development (USAID)

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